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Suicidal Violence

H/T my friends in Arizona, Great Satan: To keep the debate from veering off into the size of AR-15 magazines and pumping vast sums of money into broad mental health reform, what we need is a targeted, proven, and effective way to address firearms access by persons suffering from suicidal self-directed violence, a few of whom are also homicidal.

This is a reprint of Dr. Paul Quinnett’s thoughts on how to effectively deal with the disturbed, before they commit murder, reprinted with his permission. I don’t agree with all of his statements, but he actually is willing to have a conversation that focuses on the real issues we face, rather than just latching onto intentionally deceptive, focus group tested, “Demand a Plan” slogans.

Dr. Quinnett notes in his preface: The shooter in Newtown was suicidal first, homicidal second. This is true of most mass murderers and about 30% of domestic violence related murder-suicides.

Mass murderers never ask themselves, “And after I kill all these innocent people, how will I escape?” The “escape” is a pre-planned suicide – whether delivered by one’s own hand or by a police sharpshooter. Reducing access to firearms will surely save some lives, but such measures fail to address the source code in all these terrible tragedies: the disordered brain of an utterly hopeless mentally ill suicidal person whose reasons for releasing hell on others die with him.

The vast majority of the mentally ill are not violent, but those who become suicidal represent a special threat to themselves, and sometimes others. The so-called suicide “contagion effect” travels like a virus from one suicidal mind to another suicidal mind via the media, and most mass murders follow another event previously publicized where a “like me” suicidal, rage-filled young man kills others and then himself.

To understand the prime source code of violence – the suicidal mind – we must first understand that persistent suicidal thoughts and feelings are markers for unremitting, unendurable psychological pain and suffering. If we are thinking about killing ourselves or others, something is terribly wrong and something needs immediate attention and balm.

According to a 2008 federal survey, in one year the adult American psychological pain index was as follows:

Imagine what Congress and the President would do if a commercial airplane loaded with 100+ Americans crashed not once a year, not once a month, not once a week, but every single day, day after day after day?

Yet because suicidal people usually die alone and devastate only their family and friends, it is only when suicidal people commit mass murder that Congress rises from its lethargy. But it is not just broad mental health reform; it is bringing a laser focus to the prevention of suicide – the source code to violent injury death.

We who work to prevent suicide for a living strongly support this statement by former Surgeon General of the United States, Dr. David Satcher, “Suicide is our most preventable death.” Rather than arming our teachers, we should ask: What actionable public health knowledge do we have to reduce suicide and, with it, collateral violence toward others?

Unknown to the vast majority of the public, we actually have a lot of actionable knowledge. Published only this past September, the National Strategy for Suicide Prevention 2012 represents our best scientific thinking on how to prevent suicide and its related violence toward others. The plan includes achievable goals, objectives, and action steps.

Will it help?

Yes!

Need proof?

In 2003 our own US Air Force published a multi-year study in the prestigious British Medical Journal clearly demonstrating that a robust, mandatory, suicide prevention/mental health promotion program dramatically reduced violence of all kinds. Findings:

33% drop in suicides

18% drop in homicides

54% drop in serious family violence

30% drop in moderate family violence.

18% drop in accidental deaths (some of which were likely disguised suicides)

Several large means restriction efforts to prevent suicide have proven successful in other countries, and in the Air Force study reductions in other-directed violence were a happy and unexpected byproduct.

So let’s focus on what will work. Let’s implement our new National Strategy for Suicide Prevention 2012 now.

Implementing the National Strategy will have a wide, generalized harm-reduction effect through the improvement of the mental health of an entire nation. Remember calm, happy, mentally healthy people – including millions of America gun owners – do not kill themselves or others.

So as the gun debate unfolds let’s not get lost in the bushes of how many bullets a Bushmaster holds, but view it through this lens:

Almost all mass murderers die by suicide.

Suicide is preventable.

Prevent suicide and you prevent violence.

An estimated 39,000 Americans will die by suicide in 2013. Among them will be our children, our teenagers, our working brothers and sisters, and hundreds of doctors, police officers, firemen, and veterans. Since each 1% rise in unemployment drives up the suicide rate by 1%, America’s psychological pain index stands at an all time high. Thanks to improved safety engineering and fewer motor vehicle accident fatalities, suicide deaths now exceed those from car crashes.

So, let’s recalibrate and resource safety-focused interventions that will not only lower our nation’s psychological pain index, but lead to broad reductions in self and other-directed violence, including the risk of mass murders.

When our national grief work is done, let us memorialize our collective loss by taking bold, science-based positive actions. We have a plan. America, it is time!

Paul Quinnett, Ph.D. is President and CEO of the QPR Institute, Inc., an educational organization dedicated to the prevention of suicide @ www.qprinstitute.com. He is also Clinical Assistant Professor at the University of Washington School of Medicine Department of Psychiatry and Behavioral Health. A free e-book on preventing suicide is available from the Institute’s web site.